Solicitors Agreement For Tax Sheltered Accounts District Name:

Transcription

1 Solicitors Agreement For Tax Sheltered Accounts District Name: PROCEDURES FOR SOLICITATION OF 403(b) AND 403 (b)(7) ACCOUNTS Effective January 1, 2003 The intent of the (district name) is to provide equal access and opportunity of all agents, brokers, and companies who wish to solicit 403(b) and 403(b)(7) accounts from District employees. Individuals and companies who wish to solicit accounts from District employees must meet the requirements listed below. Failure to do so may be cause for non-acceptance of any contract submitted by that agent or representative. Companies and brokers shall be responsible for the activities of all agents and representatives, and continued disregard of these rules by individuals may result in disqualification of the parent organization. Approval: Each agent, broker or company soliciting or intending to solicit 403(b) or 403(b)(7) accounts must be approved by Kazdon, Inc., Third Party Administrator (TPA) for the District. They may be reached at to request an agent packet containing the necessary forms. Or, these forms may be downloaded from the company website at The soliciting agent must determine if the company(s) they represent appears on the list of approved companies for the District, and request an agent packet containing the required paperwork. Additionally, beginning June 1, 2002, the company must appear on the list of approved companies maintained by the Teacher Retirement System of the State of Texas (TRS) ( Requirements for approval include: a. A completed agent/representative questionnaire. b. Proof of insurance licensing, state and federal (as required). c. A Hold Harmless Agreement, executed by an officer of the soliciting company (Provider), indemnifying the District. No payroll deductions will be honored without a signed Hold Harmless Agreement from the provider. d. All agents must sign and abide by the guidelines of this solicitation agreement. State Board of Insurance: All agents soliciting Tax Sheltered Annuities must be in good standing with the Texas State Board of Insurance. Enrollment Periods: Enrollment and change applications will be accepted monthly. Any forms received on or by the 25 th of the month will be effective on the first payroll of the following month. For example: An application received by Kazdon, Inc. by August 25 th will be effective on the September payroll. Employees may stop their deductions during any month. Forms: Required standard Kazdon, Inc. forms must be completed and signed by all parties. These include a salary reduction agreement, agent questionnaire, required information statement and uniform disclosure statement (if applies). All forms, along with a copy of the account (06/04) Solicitors Agreement 1 of 3

2 application and a copy of your insurance license must be sent to the administrator. DO NOT send forms to the District Payroll, Employee Benefits, or other Business Services offices. Faxes will not be accepted only originals. Solicitation of Accounts: All agents and representatives are required to follow the Districts Board Policy CHE (Local) and Regulation CHE-R (Local). Any agent, representative, agency or marketing firm not adhering to these guidelines will forfeit their solicitation privilege. Kazdon, Inc. will work with the Districts Administration to monitor and enforce these regulations. Rules for solicitation include: 1. All agents/representatives must complete and have on file a solicitors agreement with Kazdon, Inc. 2. All agents/representatives must complete a new solicitors agreement every calendar year. 3. Solicitation of accounts on school premises is prohibited at all times, including by invitation of the employee. 4. Telephone solicitation and bulk mailings to employees at their place of employment are not acceptable. 5. Employee Directory information may be obtained, as permitted by law, from the Office of the Superintendent of the District, and may entail a minimal charge for distribution. 6. Commercial transactions between school personnel and patrons are not permitted during the instructional day. 7. Agents, representatives, agencies and marketing companies may not imply, directly or indirectly, that they represent, work with, or are associate with another company, agency or marketing firm in order to fraudulently solicit employees. 8. District property may not be used, at any time, for group presentations or seminars unless approved by or sponsored by the School District. 9. Marketing material must comply with Texas Administrative Code , Chapter 28. Information: The District shall publicize to its employees the benefits of tax sheltered saving plans, and shall make available a list of all approved companies or brokers, including those on the approved list for TRS. Mail: Mail all forms to the following address. Kazdon, Inc. TSA Department P.O. Box Austin, Texas (06/04) Solicitors Agreement 2 of 3

3 Agent Questionnaire District Name: PLEASE FILL OUT THE FOLLOWING INFORMATION. PLEASE PRINT OR TYPE. This agreement is valid for only the above named district administrated by Kazdon, Inc. Personal Information Name: Last Name First Name Middle Work address: (City) (State) (Zip) Work Phone:( ) ext Alternate Phone:( ) Fax Number:( ) Types of License(s) State License Number/Other License Numbers List carriers that you represent (Only list carriers that are on TRS Certified Company List) 1. I agree to abide by all procedures noted above concerning the solicitation and processing of 403(b) and 403(b)(7) accounts. 2. I understand that failure to follow the School Board guidelines will be cause for forfeiture of solicitation privileges and non-acceptance of contracts submitted on behalf of the school district employees. 3. I agree to comply with all pertinent written directives regarding the solicitation of Employees. By signing this Solicitors Agreement, I do hereby understand and accept the rules and regulations of this agreement. Representative s Signature Date Please Attach a Copy of Your Insurance License Mail all forms to the following address: Kazdon, Inc., TSA Department, P.O. Box 29927, Austin, Texas (06/04) Solicitors Agreement 3 of 3

4 Hold Harmless Agreement Regarding Sale of Annuities and Investments Under Section 403 (b) and 403 (b)(7) WHEREAS,, (district name), herein referred to as the "School District" desires to offer employees a payroll reduction plan for the purchase of annuities or other authorized investments under the provisions of Public Law , U.S. Internal Revenue Code Section 403(b) as amended to include 403(b)(7), and Article 6228a-5, Vernon's Texas Civil Statutes, as amended by Senate Bill 273; and WHEREAS, the School District only provides its employees Non-ERISA 403(b) and 403(b)(7) Plans; WHEREAS,, herein referred to as the "Provider" desires to provide a plan or plans complying with Federal and State law for eligible employees of the District wishing to have such accounts qualified under Section 403(b) and 403(b)(7) IRC established and purchased for them by the School District; and WHEREAS, Provider represents and warrants to School District that Provider has certified to the Teacher Retirement System Provider s compliance with Article 6228a-5, Vernon's Texas Civil Statutes, as amended by Senate Bill 273. NOW, THEREFORE, in consideration of the above stated premises and mutual covenants herein, the Provider agrees to the following: 1. The Provider shall provide or hold as an investment vehicle for purchase by the School District for its employees only accounts or products complying with the provisions of Public Law , Section 403(b) and 403(b)(7) of the U.S. Internal Revenue Code, Article 6228a-5, Vernon's Texas Civil Statutes, as amended by Senate Bill 273, and any other pertinent present or future Federal or State Law. Such accounts shall be available for any legally eligible employee electing to participate. 2. The Provider will do all things, within the scope of Provider's control or authority, necessary as a provider of the above described accounts to insure that the plan(s) offered to the District's employees comply with all applicable Non-ERISA requirements. The Provider will do nothing that causes the plan(s) provided by the Provider to be interpreted as an ERISA plan. 3. When Provider agrees to prepare a maximum exclusion allowance calculation, the calculation will be accurate assuming the information provided to Provider by the employer and/or the employee is accurate. 4. The Company, its agents and representatives shall comply with all pertinent written directives and reasonable requests regarding the solicitation of employees of the School District with respect to the purchase of tax deferred accounts or investment companies' custodial accounts. 5. The Provider agrees to make any and all tax reporting of distributions directly to the Internal Revenue Service. This includes, but is not limited to, the reporting of P.S. 58 costs on any and all life insurance plans. 6. The Provider agrees that any and all determinations regarding hardship distributions are made by Provider or the Company holding the investment for the plan. The Provider, if the holder of the investments under the plans, shall notify the School District, in writing, as to the date of any hardship distribution from an investment held by Provider, to any School District employee. 7. The Provider agrees to notify the School District of any and all excess contributions made by a School District employee to the Provider's plan(s) when the Provider holds or controls the investment vehicle. All notices and reports must be made in writing and received by the School District prior to January 10th of each year for any prior year's excess contributions. (06/04) Hold Harmless Agreement 1 of 2

5 8. The Provider agrees that any and all loan arrangements are solely the responsibility of both the Provider and the participant in the plan and that any and all reporting to governmental authorities is the responsibility of the Provider. 9. The Provider shall indemnify and hold harmless the School Board, the District (its administrators and employees), and the Third Party Administrator from every claim, cost and demand, excluding those based upon negligence of the School Board, the District (including its administrators and employees), and the Third Party Administrators, which may arise directly or indirectly from Provider's action or inaction under this Agreement. 10. The Provider, at its own expense, shall defend any legal proceedings that may be brought against the School Board, the District (its administrators and employees), and the Third Party Administrator, which may arise directly or indirectly from the Provider's actions or inaction under this Agreement. Further, the Provider shall pay the reasonable attorney's fees of the District (including its administrators and employees), and the Third Party Administrator in the event any of them desire to involve their own counsel in any such proceeding, and shall satisfy any judgment that may be rendered against any of them by reason of Provider's actions or inaction under this Agreement. The School District shall promptly notify the Provider by Registered or Certified Mail upon the receipt of any such claim or demand. 11. The Provider and the District reserve the right, upon thirty (30) days written notice to the other, by Registered or Certified Mail, to terminate this Agreement, but such termination shall in no manner affect Provider s obligations under Paragraphs 9 & 10 for any action or inaction of the Provider incurred prior to such termination. 12. This Agreement may only be modified by a written instrument signed by duly authorized representatives of the School District and Provider. 13. This Agreement shall be governed by and construed in accordance with the laws of the State of Texas. Name Date Authorized Officer of Provider Address Signature of Officer City, State, Zip Officer s Title Phone Number (Please provide area code) (06/04) Hold Harmless Agreement 2 of 2

6 SALARY REDUCTION AGREEMENT (For 403 (b) and 403 (b)(7) Salary Reduction Agreement Executed After June 1, 2002) WHEREAS, herein referred to as the Employee, desires to establish a payroll reduction plan for the purchase of annuities or other authorized investment as authorized in Section 403 (b) and 403 (b)(7) of the Internal Revenue Code and prescribed under Tex. Rev. Civ. Stat. Ann. Article 6228a-5 as amended by House Bill 1824 and Senate Bill 273. WHEREAS, (district name) herein referred to as the Employer wishes to have the Employee receive those benefits NOW THEREFORE, in consideration of the mutual premises and conditions appearing below, it is agreed: Beginning, 20 the Employer will apply the amount of the salary reduction described in paragraph below to the purchase of a nonforfeitable contract for the Employee from: (BE SURE TO LIST ALL 403(b)(7) COMPANIES NEW AND EXISTING; PLEASE DO NOT LIST FUNDS WITHIN THE CARRIER AND PLEASE PRINT) NEW INCREASE DECREASE RESUME EXISTING STOP Company Name (Carrier) Amount Per Pay Period Company Name (Carrier) Amount Per Pay Period Company Name (Carrier) Amount Per Pay Period Total Reduction PER PAY PERIOD - (ALL COMPANIES) Total ANNUAL Reduction FOR CURRENT CALENDAR YEAR (PLEASE CIRCLE ONE) HOW MANY PAYROLL DEDUCTIONS DO YOU HAVE EACH YEAR? OTHER If you are participating or would like to participate in the 15 Year Catch-Up provision (Economic Growth & Tax Relief Reconciliation Act of 2001), please complete this section: (Please consult your Financial Advisor) Age 50 or more 15 years or more with the current employer 15 years or more with the current employer and age 50 or more PLEASE NOTE: ADDRESS IS REQUIRED FOR ALL NEW ACCOUNTS ADDRESS FOR REMITTANCE OF MONEY: PLEASE READ I. The employer will apply and remit the salary reduction described above to Kazdon, Inc.. Kazdon, Inc., the Third Party Administrator (TPA) will forward funds to the provider that you have elected above. II. III. IV. Kazdon, Inc. is the TPA for the Employer s TSA Plan. Kazdon, as TPA, is providing consolidated billing services among other things for the district. It is understood and agreed between the employer and the employee that such contract is to be purchased at the request of the employee under a program adopted by the employer and that the employee hereby accepts the provision of that program, and that the employer neither guarantees such contract nor warrants adopted payroll procedures respecting same. Employee hereby releases any claims against Employer and Kazdon, Inc. arising directly or indirectly out of any statement or action taken by the above-identified provider or the performance of any product you purchased pursuant to this agreement. That this agreement is legally binding and irrevocable with respect to amounts earned while it is in effect, and shall terminate upon giving 30 days written notice to the other party. V. That no provision of this agreement shall affect the Employer s right to discharge the Employee, with or without cause, and each party to the agreement expressly reserves the right to terminate said agreement upon giving 30 days written notice to the other party. VI. The employee is completely responsible for any/all compliance issues regarding life insurance as a part of their supplemental retirement plan. This includes but is not limited to the Incidental Benefit Regulations that pertain to the contribution proportion to life insurance. (06/04) SRA 1 of 3

7 NOTICE OF CHANGE IN STATE LAW. Effective June 1,2002, companies selling 403 (b) and 403 (b)(7) products to School District employees must have certified to the Teacher Retirement System (TRS) that the carrier complies with Art. 6228a-5, Texas Civil Statues, as revised by SB 273, and TRS regulations. Additionally, the carrier or its agent must give you a disclosure statement at the time you sign an application. The district s third party administrator, Kazdon, Inc. will verify whether the carrier you intend to invest with appears on the TRS list of certified carriers and whether you have been given the state mandated disclosure statement. By signing this agreement, you acknowledge that TRS, Employer and Kazdon, Inc. do not certify, endorse, or verify that any 403 (b) or 403 (b)(7) product or disclosure statement complies with state and federal law. Participant s Signature Social Security Number of Participant Street Address Home Telephone Number (Please Provide Area Code) City, State, Zip Work Telephone Number (Please Provide Area Code) Address of Participant Date Signed Representative s Signature Representative s Telephone Number (Please Provide Area Code) Representative s Name (Please Print) Date Signed Representative s Address Salary Reduction Agreement ONLY VALID with Attached Required Information Statement, Uniform Disclosure Notice (if applies), and a copy of your account contract. Mail to: Kazdon, Inc. TSA Department P.O. Box Austin, Texas (06/04) SRA 2 of 3

8 403 (b) or 403 (b)(7) Required Information Statement Please complete this form completely Employee Name: Current Employer: Date Of Birth (mm/dd/yyyy): Date of Hire: Annual Gross Salary for 20 : $ Total 403(b) deposits while with current Employer through the end of 20 : $ Have you received a hardship distribution in the past 12 months? Yes No Are you participating in any other retirement plan? (i.e. 401(k), 457, IRA, SEP, ORP) Yes No If yes, how much were the total contributions in the past 12 months? $ Years of Service under Teacher Retirement System: Is this the final year of service: Yes No If yes, date of last paycheck: (06/04) SRA 3 of 3

9 403 (B) Maximum Annual Contribution Worksheet (Required on New Cases and Increases) If you are participating or would like to participate in the 15 Year Catch-Up provision (Economic Growth & Tax Relief Reconciliation Act of 2001), please complete this section: (Please consult your Financial Advisor) All Educators $11,000 for 2002 $12,000 for 2003 $13,000 for 2004 $14,000 for 2005 $15,000 for 2006 Educators age 50 and over who do not have 15 years of service with the current employer. $12,000 for 2002 $14,000 for 2003 $16,000 for 2004 $18,000 for 2005 $20,000 for 2006 Educators age 50 and over who do have 15 years of service with the current employer. * $15,000 for 2002 $17,000 for 2003 $19,000 for 2004 $21,000 for 2005 $23,000 for 2006 Educators with 15 or more years of service with current employer but not age 50 and over * $14,000 for 2002 $15,000 for 2003 $16,000 for 2004 $17,000 for 2005 $18,000 for 2006 * The 15-year catch-up is available for any employee who has completed 15 years of service with their current employer and who has not contributed all of the excess contributions available under the catch-up ($15,000). I certify that I am years of age and have years of service with my current employer therefore, I qualify for $ for the tax year 20. Signature (Participant) Date